Sperm Count 31 million : Is it enough for pregnancy
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By: Dr.Bhargav Raut
- 2023-08-12T09:35:07.479+00:00
What is a normal sperm count?
A normal total sperm count is 39 million as per the WHO. For the purposes of this article we assume an ejaculatory volume of 3 ml.[1.5ml - 6ml].What is Male Infertility
Male infertility is when a man and a woman try to have a baby by having unprotected sex for a whole year, but they can't make a baby. The woman is perfectly fine and can have babies, but the problem is with the man. About 20% of the time, the man is the only one to blame for not being able to make a baby.4What is it called when sperm count is 31 million/ml?
This condition is called oligospermia or a low sperm count.How is sperm count measured?
A sperm count is assessed by means of a semen analysis test. In this test you are asked to provide a sample of your semen, and the lab uses special techniques to analyze the semen. The count is estimated by diluting the semen in a special diluent and then using a measurement chamber to visualize the sperms. A complex mathematical formula is employed to estimate the actual sperm count.What is my grade of oligospermia?
Your sperm count is slightly lower than the normal range. Typically, a normal sperm count is considered to be above 39 million, and yours is at 31 million. This condition is called oligospermia, specifically mild oligospermia in your case. It means that the number of sperm in your semen is relatively low. While your count is slightly below the normal range, it is still within a mild range of oligospermia.What are the causes of a sperm count of 31 million?
There are several different causes of oligospermia and they can be one of several categories including due to genetic factors, past cancer, secondary to other diseases, physical factors in the reproductive tract etc.5Hyperthyroidism - Hyperestrogenic State
Hyperthyroidism is a condition where the thyroid gland produces an excessive amount of thyroid hormones. This leads to a hyperestrogenic state, meaning that there is an increase in estrogen levels in the body. This hormonal imbalance can affect sperm production and quality. To investigate this cause, a blood test can be done to measure the levels of thyroid hormones, such as TSH, T3, and T4.Craniopharyngioma - Mass Effect Disrupts LH, FSH Production
Craniopharyngioma is a type of brain tumor that can cause a mass effect, meaning it puts pressure on nearby structures. In this case, it disrupts the production of LH (luteinizing hormone) and FSH (follicle-stimulating hormone) by the pituitary gland. These hormones are responsible for stimulating the testes to produce sperm. To investigate this cause, imaging tests like MRI or CT scans can be done to visualize the tumor and its effects on the pituitary gland.Medications - Anabolic Steroids Suppress the Hypothalamo-Pituitary Axis
Anabolic steroids are synthetic substances that mimic the effects of testosterone. However, their use can suppress the hypothalamo-pituitary axis, which is responsible for regulating hormone production. This disruption can lead to a decrease in sperm count. To investigate this cause, a thorough review of the patient's medication history and potentially drug screening tests can be done.Varicocele - Sloughing, Atrophy, Low Testosterone
Varicocele is a condition where the veins within the scrotum become enlarged. This can lead to sloughing (shedding) of sperm, testicular atrophy (shrinkage), and low testosterone levels. To investigate this cause, a physical examination of the scrotum can be done to detect any abnormalities, and ultrasound imaging can be used to assess the blood flow in the veins.Hemochromatosis - Infiltrative Pituitary Disruption
Hemochromatosis is a genetic disorder where the body absorbs and stores too much iron. This excess iron can infiltrate the pituitary gland and disrupt its normal function. This disruption can affect sperm production. To investigate this cause, blood tests can be done to measure iron levels in the body, such as serum ferritin and transferrin saturation.Infections - Prostatitis
Prostatitis is an infection or inflammation of the prostate gland. This infection can affect sperm production and quality. To investigate this cause, a physical examination of the prostate gland can be done to check for signs of infection, and a urine sample can be analyzed for the presence of bacteria or white blood cells.Infections - Mumps Orchitis
Mumps orchitis is a complication of the mumps virus that affects the testicles. It can lead to inflammation and swelling, which can affect sperm production. To investigate this cause, a medical history review, physical examination, and potentially blood tests to detect mumps antibodies can be done.Pituitary Adenoma - Exerts Mass Effect on the Gonadotrophs
A pituitary adenoma is a non-cancerous tumor that develops in the pituitary gland. It can exert a mass effect on the gonadotrophs, the cells responsible for producing LH and FSH. This disruption can lead to a decrease in sperm count. To investigate this cause, imaging tests like MRI or CT scans can be done to visualize the tumor and its effects on the pituitary gland.Congenital Adrenal Hyperplasia - Unregulated ACTH Production
Congenital adrenal hyperplasia is a genetic disorder where there is an abnormality in the production of cortisol by the adrenal glands. This can result in excess adrenal androgens, which can suppress the pituitary gland and affect sperm production. To investigate this cause, blood tests can be done to measure hormone levels, such as ACTH, cortisol, and adrenal androgens.Klinefelter's Syndrome - Chromosomal Abnormality
Klinefelter's Syndrome is a chromosomal abnormality where males have an extra X chromosome (XXY instead of XY). This can lead to hormonal imbalances and testicular dysfunction, resulting in reduced sperm production. Some men with this syndrome may be totally azoospermic (no sperm), while others may have oligospermia (low sperm count). To investigate this cause, genetic testing can be done to detect the presence of an extra X chromosome.Questions to ask yourself for a sperm count of 31 million
Age at which you had puberty
Have you ever experienced any physical changes in your body, such as growing taller, developing facial hair, or experiencing voice changes, around the age when most boys go through puberty?Surgery on testicles
Have you ever undergone surgery on your testicles? If so, please provide details.Any trouble with sexual drive or function
Have you ever experienced any difficulties with your sexual drive or function?Sexually transmitted infections
Have you ever been diagnosed or treated for any sexually transmitted infections in the past?Infections of prostate or testicle
Have you ever experienced any infections or inflammation in your prostate or testicles?Current and former medications
Have you ever taken any medications, either currently or in the past, that could potentially affect your sperm count?Use of alcohol, tobacco, illicit drugs
Have you ever consumed alcohol, tobacco, or illicit drugs? Please mention any instances, as it may help us understand the potential factors affecting your sperm count.Systemic disease
Have you ever been diagnosed with or experienced any long-term health conditions that could affect your overall reproductive health, such as diabetes, high blood pressure, thyroid problems, or any other chronic diseases?Environmental exposures, including radiation, pesticides, and occupational
Have you ever worked in a job or been exposed to radiation, pesticides, or other chemicals that could potentially affect your fertility?Any Cancer diagnosis or treatment
Have you ever received a diagnosis of cancer or undergone any cancer treatments that might have affected your fertility?What will be done during medical checkup for sperm count of 31 million?
Is your sexual development complete ? - Tanner stage
In order to determine if your sexual development is complete, the doctor will perform a Tanner stage examination. This examination involves looking at the physical changes in your body that occur during puberty. The doctor will assess the development of your genitals, the growth of body hair, and the changes in your voice. They may also ask about any changes you have noticed in your sexual desires or abilities. This examination will help the doctor understand if your sexual development is progressing normally or if there may be any underlying issues that need to be addressed.Do you show signs of a mass in the brain? - Bitemporal hemianopsia (pituitary mass)
In order to determine if there is a mass in your brain causing bitemporal hemianopsia, the doctor will perform a thorough examination. This will involve asking you questions about your symptoms and medical history. The doctor may also conduct a physical examination, checking your vision and evaluating your overall neurological function. Additionally, the doctor might order further tests such as an MRI or CT scan to get a detailed picture of your brain and identify any abnormalities. Based on the findings, the doctor will be able to determine if there is indeed a mass in your brain that is causing the bitemporal hemianopsia.Is your testicle size normal ? Reduced testicular volume (<15 cc)
The doctor will examine the size of your testicles to see if they are normal. This involves feeling the testicles with their hands. They will check if the size is smaller than what is considered normal, which is usually less than 15 cc. If the testicles are smaller, it could indicate a problem with sperm production. This could be one of the reasons for the low sperm count of 31.Is there a mass in your testicle? - Testicular mass
The doctor will perform a physical examination to check for any abnormalities in the testicles. This may involve gently feeling the testicles to check for any lumps or masses. The purpose of this examination is to determine if there is any presence of a testicular mass, which could be a possible sign of a medical condition. It is important for the doctor to assess this as it may help in diagnosing any underlying issues and providing appropriate treatment if necessary.Is the natural tube from testicles missing from either side? - Presence of vas deferens bilaterally
The doctor will examine the patient to see if the natural tube connecting the testicles is missing on either side. This tube is called the vas deferens and it plays a crucial role in carrying sperm. The examination will involve a physical examination of the patient's scrotum and groin area to look for any signs of absence or blockage of the vas deferens. The doctor may also order additional tests such as a semen analysis or imaging studies to further evaluate the condition. The results of this examination will help determine the cause of the patient's low sperm count and guide the appropriate treatment options.Is there any cyst or swelling in the testicular sac ? - Presence of varicocele or other scrotal mass
The doctor will carefully examine the patient's testicular sac to check for any cyst or swelling. This involves feeling the scrotum with their hands to detect any abnormal lumps or masses. If there is a varicocele, which is a condition where the veins in the scrotum become enlarged, it can be felt during this examination. The doctor will gently apply pressure to the scrotum to assess for any discomfort or pain. This examination helps the doctor determine if there are any abnormalities in the testicles that could be affecting the patient's sperm count.Are the testicles missing? - Presence of cryptorchidism or hypospadias
The doctor will check if the testicles are missing by physically examining the patient's groin area. They will gently feel for the presence of the testicles, which should be located inside the scrotum. If the testicles cannot be felt there, it could indicate a condition called cryptorchidism, where the testicles have not descended into the scrotum. In addition to this, the doctor will also check for the presence of hypospadias, a condition where the opening of the urethra is not at the tip of the penis, but is located on the underside. These examinations will help the doctor determine the possible reasons for the patient's sperm count of 31.
Is there any joint problem ? -Synovitis of second and third metacarpal-phalangeal joints, 'bronzed' appearance or stigmata of liver disease or heart failure (hemochromatosis)
The doctor will check if there are any issues with the joints in the patient's hands. Specifically, they will examine the second and third knuckles to see if there is inflammation called synovitis.Additionally, the doctor will look for any unusual changes in the color of the patient's skin, which may appear like a bronze or tan appearance. This could be a sign of liver disease or heart failure, a condition called hemochromatosis.
The examination will involve a visual inspection and possibly some physical tests to assess any joint problems or signs of liver or heart issues. This will help the doctor determine the best course of action for the patient's overall health.